title: The BraveNet prospective observational study on integrative medicine treatment approaches for pain.
abstract: Chronic pain affects nearly 116 million American adults at an estimated cost of up to $635 billion annually and is the No. 1 condition for which patients seek care at integrative medicine clinics. In our Study on Integrative Medicine Treatment Approaches for Pain (SIMTAP), we observed the impact of an integrative approach on chronic pain and a number of other related patient-reported outcome measures.
  
  
  
  Our prospective, non-randomized, open-label observational evaluation was conducted over six months, at nine clinical sites. Participants received a non-standardized, personalized, multimodal approach to chronic pain. Validated instruments for pain (severity and interference levels), quality of life, mood, stress, sleep, fatigue, sense of control, overall well-being, and work productivity were completed at baseline and at six, 12, and 24 weeks. Blood was collected at baseline and week 12 for analysis of high-sensitivity C-reactive protein and 25-hydroxyvitamin D levels. Repeated-measures analysis was performed on data to assess change from baseline at 24 weeks.
  
  
  
  Of 409 participants initially enrolled, 252 completed all follow-up visits during the 6 month evaluation. Participants were predominantly white (81%) and female (73%), with a mean age of 49.1 years (15.44) and an average of 8.0 (9.26) years of chronic pain. At baseline, 52% of patients reported symptoms consistent with depression. At 24 weeks, significantly decreased pain severity (-23%) and interference (-28%) were seen. Significant improvements in mood, stress, quality of life, fatigue, sleep and well-being were also observed. Mean 25-hydroxyvitamin D levels increased from 33.4 (17.05) ng/mL at baseline to 39.6 (16.68) ng/mL at week 12.
  
  
  
  Among participants completing an integrative medicine program for chronic pain, significant improvements were seen in pain as well as other relevant patient-reported outcome measures.
  
  
  
  ClinicalTrials.gov, NCT01186341.
authors.affiliation: UCSF Osher Center for Integrative Medicine,University of California San Francisco,1545 Divisadero Street, 4th Floor, San Francisco, CA 94115, USA
authors.forename: Donald I
authors.initials: DI
authors.lastname: Abrams
authors.affiliation: Duke Clinical Research Institute, Duke University Health System, Durham,
  NC, USA
authors.forename: Rowena
authors.initials: R
authors.lastname: Dolor
authors.affiliation: Duke Clinical Research Institute, Duke University Health System, Durham,
  NC, USA
authors.forename: Rhonda
authors.initials: R
authors.lastname: Roberts
authors.affiliation: Bravewell Collaborative, Minneapolis, MN, USA
authors.forename: Constance
authors.initials: C
authors.lastname: Pechura
authors.affiliation: Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN, USA
authors.forename: Jeffery
authors.initials: J
authors.lastname: Dusek
authors.affiliation: Alliance Institute for Integrative Medicine, Cincinnati, OH, USA
authors.forename: Sandi
authors.initials: S
authors.lastname: Amoils
authors.affiliation: Alliance Institute for Integrative Medicine, Cincinnati, OH, USA
authors.forename: Steven
authors.initials: S
authors.lastname: Amoils
authors.affiliation: UCSF Osher Center for Integrative Medicine,University of California San Francisco,1545 Divisadero Street, 4th Floor, San Francisco, CA 94115, USA
authors.forename: Kevin
authors.initials: K
authors.lastname: Barrows
authors.affiliation: Myrna Brind Center of Integrative Medicine, Thomas Jefferson University, Philadelphia, PA, USA
authors.forename: Joel S
authors.initials: JS
authors.lastname: Edman
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, USA
authors.forename: Joyce
authors.initials: J
authors.lastname: Frye
authors.affiliation: Scripps Center for Integrative Medicine, La Jolla, CA, USA
authors.forename: Erminia
authors.initials: E
authors.lastname: Guarneri
authors.affiliation: Continuum Center for Health and Healing, Beth Israel Medical Center, New York, NY, USA
authors.forename: Ben
authors.initials: B
authors.lastname: Kligler
authors.affiliation: Myrna Brind Center of Integrative Medicine, Thomas Jefferson University, Philadelphia, PA, USA
authors.forename: Daniel
authors.initials: D
authors.lastname: Monti
authors.affiliation: Venice Family Clinic, Venice, CA, USA
authors.forename: Myles
authors.initials: M
authors.lastname: Spar
authors.affiliation: Duke Integrative Medicine, Duke University Health System, Durham, NC, USA
authors.forename: Ruth Q
authors.initials: RQ
authors.lastname: Wolever
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000339:Affect; D059350:Chronic Pain / Q000628:therapy; D003863:Depression / Q000628:therapy; D005221:Fatigue / Q000628:therapy; D055048:Integrative Medicine; D059408:Pain Management; D011446:Prospective Studies; D011788:Quality of Life; D012890:Sleep; D013315:Stress, Psychological / Q000628:therapy; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: C104450:25-hydroxyvitamin D; D014807:Vitamin D